Damian Sendler: By the year 2020, scientists around the world will have spent a great deal of time and energy trying to figure out what COVID-19 is. It is our contention in this review that, despite the fact that COVID-19 is clearly a biological disease linked to a specific virus, the culture–mind relation at the heart of cultural psychology is nonetheless essential to understanding the pandemic, which we discuss in some detail between the outbreak of this pandemic and 2020. COVID-19 has been politicized in a wide range of ways, including in terms of relative mortality, transmission rates, behavioral responses, official policies, and compliance with authorities, among others. Many minority groups have had very different experiences of the pandemic than dominant groups, due to existing health inequities and discrimination and marginalization, which we believe calls for a better integration of political and socioeconomic factors into cultural psychology and the narrative of health or illness in psychological science in general. Cultural context influences individual differences in intolerance of uncertainty or optimism or conspiracy thinking or collectivist orientation, which has implications for behaviors relevant to the spread and impact of COVID-19, such as mask-wearing or social distancing. It has long been known that cultural context has an impact on mental health, but the current research extends this thinking to infectious disease, with special attention paid to diseases spread by social contact and fought at least in part by social interventions. COVID-19’s transmission, course, and outcome will be examined on three levels of cultural influence: There are three types of cultural differences: differences between societies; communities within societies; and relationships between groups. Finally, we discuss theoretical and practical implications of this perspective on infectious disease for cultural psychology and related disciplines, and for public health interventions.
Damian Jacob Sendler: More than 70,000 articles on COVID-19 are expected to be published by the global scientific community in 2020. (Pujol, 2020). To a large extent, this research focused primarily on learning about and developing a vaccine for a particular strain of virus, rather than studying how the virus itself spreads or how it can be treated. As the pandemic spreads across the globe, researchers have studied how people are behaving and the social, political, and psychological factors that have contributed to this spread. With this review, we hope to show that this growing body of research is not only relevant to understanding how culture and mind shape COVID-19, but also points toward a framework on which an infectious disease cultural perspective can be built. Our conclusion is that the study of infectious diseases can benefit greatly from cultural psychology.
Dr. Sendler: First-year findings from cultural psychology research are highlighted in our selection of topics, which also serves as a limitation on this rapidly expanding field. However, the pandemic situation is constantly changing. Our knowledge of the relationship between culture and COVID-19 will continue to expand as new variants are discovered and vaccines are made available around the world. Our conclusions and proposed framework may be bolstered, contradicted, or complicated by future findings. In addition, as we gather more and better data, our conclusions may change, and the pandemic occurs during a time of rapid cultural and historical change. It is possible that the relationships between variables will change over time, especially as policymakers, journalists and scientists respond to the ever-growing COVID-19 database. Because of the conceptual and empirical tools provided by cultural psychology, we are confident in our ability to carry out time-sensitive research with rigor while also gaining a better understanding of how the picture might shift over time (see Gergen, 1973).
Most published research on COVID-19 behavioral responses focuses on local contingencies, particularly in the United States. We will expand some recently proposed pandemic responses into a wider, global context. If we want to understand the pandemic, we need to look at it through the lens of cultural and cultural-clinical psychology, as well as broader socioeconomic contexts, in order to gain a deeper understanding of how the mutual constitution of culture and mind are affected by larger socioeconomic dynamics. This is our primary goal. To that end, we’d like to open a line of communication with experts in related fields (such as health psychology and medical anthropology) so that they, too, can benefit from our insights. It has been common practice in traditional health sciences to look at local health and illness from a Western perspective. For example, a meta-theoretical approach to cultural psychology encourages us to think about how science itself might be a manifestation of cultural bias in our understanding of human behavior (see also Hoshmand, 1996; Adams and Salter, 2007).
How can cultural psychology and cultural-clinical psychology help us understand the global development of the pandemic, given what we learned in 2020? That is the research question that guides this paper’s research. Literature from around the world, including regions of the globe that aren’t represented as frequently as the Global North, will be included in our coverage where possible (see Adams and Salter, 2007). Our first step will be to introduce you to cultural and clinical psychology and how it can be applied to infectious disease research. As a result, we’ll look at three levels of interrelation between culture and mind in the context of the pandemic: (1) across societies, in which “country” or “region” is the unit of analysis and used as a proxy for “culture;” and (2) within cultures, where “mind” is used as a proxy for “culture.” Second, within a given country or region, where cross-cultural variation is observed across ethnocultural communities and in the relations between them; third, in individuals, where cultural differences can be observed in person-level characteristics. Our next step will be to discuss how a cultural psychology approach to infectious disease can be applied in the real world.
Psychology has a number of sub-disciplines that look at how the mind and behavior of humans interact with their social and cultural surroundings. “Big tent” and pluralistic approaches are taken to cultural psychology in this article, which includes cross-cultural and ethnic minority psychology as well as other subdisciplines within the social sciences that have similar concerns (e.g., psychological anthropology, cognitive sociology). This is in line with the interdisciplinary nature of cultural psychology, particularly the crucial links with anthropology that it makes (Shweder, 1991; Chirkov, 2016).
The core concepts of cultural psychology are, however, at the heart of our understanding. For starters, we define culture as “the set of meanings (e.g… values; beliefs; knowledge; norms) that are required for a community to function” (Goodenough, 1994). Second, we believe that cultural meanings can be observed in the world in the form of practices and products that are understood by everyone and that support these meanings in the context of society (Ryder et al., 2011; Morling, 2016). As a third point, we follow Shweder (1991) in conceiving of culture and mind as mutually constitutive; we cannot fully understand one without the other. Culture, mind, and the brain all “make each other up,” thanks to the rise of cultural neuroscience and neuroanthropology (Kitayama and Uskul, 2011; Ryder et al., 2011). We believe that people should be understood in context, but not reduced to their contexts, and especially not to generalized stereotypes of their cultural groups. This is our fourth principle. Rather than simply “dispositional tendencies,” cultural psychology’s individual differences are a manifestation of each person’s history of engaging with their available cultural affordances and, as we argue in this paper, the sociopolitical dynamics of power that permeate cultural ecologies.
When looking at aggregate scores, it is important to remember that each score conceals a multitude of individuals who may either conform to or defy the local consensus. This can be done by resisting the local consensus and amplifying it, or by consciously rebelling against it. Cultural psychology places an emphasis on “unpacking culture,” starting with observations and moving toward explanations of why cultural group differences are observed, which is in line with this point of view (Heine and Norenzayan, 2006). Keep in mind that these explanations don’t rule out the possibility of individual variation. To put it another way, it’s possible to better understand how the wealthy members of a disadvantaged group might have better health outcomes than simply treating them as outliers if the group difference in health outcomes is due to wealth disparity.
Psychopathology and its treatment can be seen through a cultural lens thanks to cultural-clinical psychology, which has emerged in the last decade at the crossroads of cultural psychology and clinical psychology (Ryder et al., 2011; Chentsova-Dutton and Ryder, 2019). It is in keeping with the cultural psychology’s interdisciplinary spirit that cultural-clinical psychology interacts with a number of other adjacent disciplines, including health-related disciplines that are less well-known to cultural psychologists. As a viral infection, there are some similarities to COVID-19 that warrant further investigation. In particular, infectious diseases spread and have an impact on a population due in part to social behaviors that are influenced by culturally shared beliefs in that population, which in turn influence the spread of the disease. The theory of planned behavior, in which attitudes, perceived social norms, and a sense of control combine to predict health-related behavioral intentions (e.g., Godin and Kok, 1996; Montao and Kasprzyk, 2015), has parallels in social psychological approaches that have proven useful in public health.
An approach to mental illness borrowed from the social sciences of medicine and applied to clinical psychology is known as cultural-clinical psychology. Disease and illness are distinct in this view, with the disease being the underlying biological dysfunction, and the illness being the sufferer’s subjective experience of it (Boorse, 1975; Eisenberg, 1977). Sickness is then used as a third term to describe the social context in which this experience occurs (Twaddle, 1973). However narrowly focused a researcher may choose to go—for example, how the novel coronavirus interacts with lung tissue (disease), or the subjective experience of determining whether one’s breathing problems are sufficient to warrant a hospital visit (illness), or local beliefs that stigmatize the recovering patient as being careless or unclean (illness)—the larger goal should be to incorporate these fins.
It is possible to think about the cultural psychology of viral diseases if we pay attention to the interplay between psychological and sociocultural aspects. An important concept in the study of culture and mental health is that beliefs and physiological processes can interact to produce strikingly different symptoms in different cultural contexts (Kirmayer and Sartorius, 2007; Ryder and Chentsova-Dutton, 2015). According to Hacking (1995), the definitions of human-made categories inevitably shift over time because of the feedback loops that arise when people learn about, debate, contest, or otherwise respond to the categories themselves. It has been argued by cultural psychiatry and cultural-clinical psychology that similar looping patterns in different cultural contexts can lead to distinct disorders.
Take Clark’s (1986) panic attack model for example. There is a physical sensation such as a racing heart or tightening of the chest. As they believe these sensations are a sign of heart trouble, they become more concerned and pay more attention to them. The autonomic nervous system is activated, resulting in a variety of additional sensations, such as chest pain and an increased heart rate. However, people have a wide range of interpretations of what various sensations mean. It’s not uncommon to experience neck stiffness or flushing in Cambodia because of local beliefs about the human body. Autonomic arousal can exacerbate these symptoms (Hinton et al., 2001). Although the autonomic nervous system’s shared biology and cultural beliefs produce a wide range of symptoms, they all share a common core (Ryder and Chentsova-Dutton, 2015). Because of universal looping processes, different symptomatologies and diagnostic categories are generated in different cultural contexts..
Infectious disease looping effects have not yet been extensively studied from a psychological perspective, but medical anthropologists have observed similar patterns (e.g., Alenichev, 2021). The virus itself is not directly affected by people’s beliefs, and this is why the infection’s core symptoms aren’t so readily apparent. The infection rate of a communicable disease can be influenced by a person’s or group’s collective beliefs, however. As a result of these processes, the virus itself can be mutated, as certain practices increase the likelihood of random genetic mutations. There are a lot more things that can be predicted about the effects of certain beliefs, such as whether or not to trust politicians or doctors, whether or not to wear a mask when you’re sick, or whether or not to shake hands when you meet someone for the first time.
For example, if individualistic values in a given cultural context are associated with higher perceived danger and lower trust in authority, that could increase fear—and if increased fear leads to more conspiratorial thinking and a reduced willingness to take protective measures, infection rates could worsen, which could lead to more fear, perhaps even less trust of the authorities reporting those rates and s. This is where looping effects can be examined: In social networks, these looping effects can also be examined, and that level might be the most important for a socially transmitted disease transmission. Even if one person holds a particular belief, it will have little effect on the spread of infectious disease; however, if a large number of people hold the same view, it could. Values and beliefs that have been shaped by culture often have their origins in political and economic factors. As an illustration, a lack of trust in health authorities and poorer health services in some neighborhoods could be the result of discrimination against marginalized groups and the accompanying stigma. As a result, the “disease-prone” stereotypes could be reinforced by higher rates and greater symptom severity in undervalued groups. When a disease’s impact interacts with social disadvantage, it can lead to drastically different illness experiences, as seen in population and public health research on syndemics (Singer et al., 2017).
“Beliefs” have so far been discussed in broad strokes. Thoughts can be understood in a systematic way in cultural-clinical psychology, as aspects of cultural models, clusters of agreed-upon assumptions with associated behaviors in the form of cultural scripts. Think of the classic example of the restaurant script, where people have shared assumptions about how to book a table, check one’s coat, be seated, read the menu, and so on. These ideas are derived from work in cognitive science (Schank and Abelson, 1977). Individuals’ relationships to their groups, their environment, and even themselves are shaped by cultural scripts that evolve over time. It is possible to organize one’s beliefs about optimal, normal, suboptimal, and pathological functioning using general cultural models of normativity and deviancy in the health domain (Chentsova-Dutton and Ryder, 2020). Although this method has primarily been used to treat mental illnesses, it can also be used to treat physical ailments. The “thresholds of concern” established by cultural models of health and illness, as well as scripts for specific disorders (such as COVID-19), assist people in making decisions. As a case in point, what sensations should I keep an eye on? Is there anything I can look out for to see if I’m ill? Is there a way to describe the recovery process? If a new disease like COVID-19 emerges and a new understanding and experience of infectious diseases is gained, these scripts can evolve rapidly.
Damian Jacob Markiewicz Sendler: Analyzing infectious disease outcomes in different countries or regions can help us better understand the interplay between culture and the mind. Methods developed by cross-cultural psychologists have made it possible to compare a large number of societies. As a result, each country or autonomous territory is treated as a distinct entity in these studies. For traits like extraversion or values like individualism-collectivism, society-level averages can be found in large-scale studies of personality traits and values. These averages can then be used as a starting point for future cross-societal research projects.
With the help of Murray and Schaller (2010), researchers can examine how infectious disease risk may have influenced cultural differences across time and space. Human sociality can be explained by the parasite-stress model, which states that people in areas with a history of high infectious disease risk will develop social practices that limit contact with unfamiliar people. Studies have shown that lower levels of extraversion and openness to new experiences, as well as lower levels of individualistic (vs. collectivistic) values (Fincher et al., 2008) and conformity (Murray et al., 2011) are linked to higher levels of historical pathogen prevalence (Schaller and Murray, 2008), all of which limit extensive social contacts with members of outgroups.
There are some limitations to conducting cross-cultural research. Poorer countries (Muurlink and Taylor-Robinson, 2020) and countries where COVID-19 infections were under-reported (Silva and Figueiredo Filho, 2020), Brazil (Freire, 2020; Silva and Figueiredo Filho, 2020), China (Colson, 2020), the US (van Beusekom, 2020), and Russia have lower data reliability (Kofanov et al., 2020; Nechepurenko, 2020). In order to overcome these limitations, we believe that cross-cultural studies on infectious diseases should continue to incorporate data collection disparities from various countries.
People’s beliefs about illness, conformity, and the importance of balancing health and economic concerns are all influenced by cultural values. Many studies have been done on this topic, with a focus on individualism and collectivism. Interest in tightness-looseness has also increased recently. COVID-19 has been studied in terms of both dichotomies.
In cultural psychology literature, it has been established that in individualistic cultural contexts, an independent construal of self, as well as freedom and fulfillment of personal goals, are prioritized; in collectivistic societies, group ties and responsibilities are perceived to be more important (Triandis et al., 1986; Markus and Kitayama, 1991). Individualistic societies may be reluctant to implement mandatory measures like lockdowns and mandatory mask-wearing in response to COVID-19, resulting in delayed responses to public health emergencies in the pandemic context. There is also a possibility that people in those societies are less familiar with public health guidelines for the most common infectious diseases (e.g., wearing a mask whenever one has cold or flu symptoms).
Indeed, between March and May of 2020, the number of COVID-19 cases and deaths in countries with a more individualistic culture was significantly higher (Jiang et al., 2020). It has been shown that collectivism is associated with less disease incidence and death per million people across cultures, but GDP per capita has a greater impact on predicting these variables (Webster and colleagues, 2021). This highlights the importance of the interplay between cultural and socioeconomic factors in research and public policy. By the end of August 2020, the fatality rate was still higher in more individualistic countries, according to newer data (Melton, 2020, preprint). According to Webster et al. (2021), which studied the effects of COVID-19 on the states of the United States, states that were more collectivistic had a higher rate of both cases and deaths, but states with a more diverse racial-ethnic composition were more likely to have both. The impact of COVID-19 may be better predicted by systemic racial health disparities than by collectivism.
Damian Sendler
Health and illness have been linked to individualism and collectivism in terms of how people conceptualize the ontological reality of the two. Health care models are based on analytic thinking and zero-sum reasoning in Western educated and individualist populations, respectively (Choi et al., 2007). Analytic thinking is characterized by an examination of each discrete component of a system as separate and independent from the whole (Nisbett et al., 2001). Medical approaches based on this model tend to focus on a specific set of symptoms or a specific disorder, rather than focusing on the underlying cause of an illness (Good, 1993; Jayasundar, 2010). This type of thinking can be found in people who are more socially oriented and do not have Western-based education, and it is characterized by looking at the relationships between all the parts of a system to see how they all fit together to form a larger whole (Nisbett et al., 2001). Various holistic medical systems, such as Ayurveda, Traditional Chinese Medicine, and Indigenous medical systems (Dahlberg and Trygger, 2009; Auger et al., 2016), view illness as an imbalance in functioning within the individual’s physical and psychological systems and in the community and broader environmental context (Dahlberg and Trygger, 2009; Jayasundar, 2010; Koo and Choi, 2016). COVID-19 is understood and addressed in a different way depending on the cultural reasoning style and associated medical model of the individual. Ayurvedic doctors and researchers have examined COVID-19 in terms of how the disease functions within a larger weakened system and proposed that treatment should focus on ensuring that global bodily functions are supported while strengthening the immune and respiratory systems to prevent infection and ease the course of disease should one contract the virus. They also support vaccinations (Niraj and Varsha, 2020; Rajkumar, 2020; Rastogi et al., 2020).
Damien Sendler: Even more importantly, the country-level measure of societal rules’ strictness may be related to the formal and informal enforcement and subsequent adherence to restrictive measures like social distancing and stay-at-home orders. As a case in point, stricter societies may enforce lockdown measures with a lower tolerance for non-compliance, while looser societies may adopt more lax regulations, allowing viral spread. Using data from 54 countries, Cao et al. (2020) found that the pandemic had a significant impact on the interplay between individualism and collectivism and three different measures of tightness-looseness. Individualism and looseness were found to be positively correlated with an increase in cases and deaths reported per million residents, as well as an increase in the case fatality rate. Between the 16th and 45th days of lockdown implementation, the countries with the most severe increases in deaths per million population had a combination of higher individualism and higher looseness (Cao et al., 2020).
Relational mobility is defined as the degree to which interpersonal relationships are established or established by choice in a given group or society (Thomson et al., 2018). With greater relational mobility, there are more options for new connections in a wide range of different social circles, while with lower relational mobility, there are fewer options for new connections and instead focus on maintaining existing connections in smaller social circles. Culture’s variation in relational mobility is rooted in its history of subsistence farming structures, with more mobile and independent subsistence styles associated with higher relational mobility (Thomson et al., 2018).
It’s possible that the novel coronavirus’s potential carriers will travel across different regions, increasing the likelihood of new cases emerging in various regions due to relational mobility in the context of infectious diseases. According to a study published in 2020, Salvador et al. (2020) analyzed the correlations between relational mobility and the number of COVID-19 cases and deaths in the first 30 days of the outbreak in 39 different countries using country-level scores for relational mobility (Thomson et al., 2018) and publicly available pandemic data from Johns Hopkins University. In countries with a high degree of social mobility, both the number of cases and the number of deaths grew significantly faster. To put it another way, people who are more open and less likely to keep to themselves may be at risk of the spread of COVID-19 in more open sociocultural ecologies.
We can attempt to integrate a cultural psychology perspective with a wide range of political and socioeconomic considerations by looking at how different groups within the same society experienced, reacted to, and were impacted by the pandemic. To begin, we’ll take a look at how different age groups and genders were impacted in different countries. As a result, we’ll look at how COVID-19 outcomes are influenced by the dynamics of polarization, power, oppression, and privilege that are profoundly linked to cultural scripts.
Through social amplification, the impact felt by different communities has an impact on their perceptions of the risk of contracting COVID. COVID-19 is perceived as more dangerous by those who have had first-hand experience with the virus or who have heard about it from friends and family (Dryhurst et al., 2020). People who are attempting to make sense of an unfamiliar and ambiguous situation tend to seek guidance from those in their immediate social circles about what to believe (Biron et al., 2020), making the sudden shifts brought on by the pandemic an ideal setting for the spread of new behaviors and beliefs. Even in societies where cultural scripts are still forming, the transmission of infectious diseases can be influenced by normative behavioral patterns within specific social networks, as well as ideas about disease causes, consequences and protections and treatments. People can learn about beliefs and behaviors through conversation or observational learning (Debiec and Olsson, 2017), but they can also learn about them from traditional news sources or social media (Collinson et al., 2015; Kilgo et al., 2018; Taylor, 2019). Participation in community events like festivals, weddings, and funerals demonstrates the importance of social connectedness. It’s possible that health officials will have no choice but to impose measures that run counter to local cultural norms. For many cultural groups and communities, obstructing worship services and especially the burial of the deceased can be emotionally charged (Schoch-Spana, 2004; Baum et al., 2009). Immigrant communities may suffer as a result of travel restrictions if they are unable to reunite with loved ones back home or attend the funerals of friends and family who have passed away.
Individuals who belong to a minority cultural group may face a variety of challenges that are not faced by members of the majority (Taylor, 2019). Prejudice and discrimination exacerbate these stressors, which we will discuss in greater detail below. Although some minorities, such as recent immigrants, may face additional challenges even in the absence of discrimination (Kirmayer et al., 2011). For example, medical professionals and public health officials may encounter language barriers in communicating effectively about health issues (Brisset et al., 2014; Doucerain et al., 2015; Zhao et al., 2019). Uncertainty about where to find community resources or the status of one’s visa can be a source of additional anxiety. During a pandemic, there may be additional difficulties in accessing medical services, information about constantly-changing local regulations, or government programs for financial relief, resulting in greater psychological consequences (Taylor, 2019).
Damian Jacob Sendler
Cultural and other socio-demographic intersections, such as gender, age, and social class, influence the spread of infectious diseases and the number of cases reported in different countries around the world. Anker and Arima (2011) found more dengue cases in men over the age of 15 in Southeast Asia than in any other gender-by-age group. Men are more likely to be exposed to mosquitoes during the day than women, according to local cultural norms. It’s possible to learn more about how cultural differences affect the likelihood that a person will become infected with an infectious disease and seek medical attention if they develop symptoms by stratifying data by age and gender.
In addition to COVID-19 risks, the pandemic’s impact on sex and gender has been shaped by the intersections of gender and cultural practices.. Globally, the disease has killed more men than women; some researchers believe this is due to behavioral factors rather than biological differences, while others believe that women’s immune systems are better equipped to fight the virus (Galasso et al., 2020; Pujol, 2020). (Takahashi et al., 2020; Zeng et al., 2020). Gender differences in behavior may be influenced by regional cultural and religious norms. According to Muurlink and Taylor-Robinson (2020), women in more conservative Muslim cultures may benefit from wearing niqabs or burkas as a barrier against the spread of disease through face-to-face contact. When it comes to men, cultural preferences for facial hair may increase the risk of exposure to the virus by compromising the seal of face coverings (Muurlink and Taylor-Robinson, 2020). Gender segregation and varying levels of participation in various spheres of society (e.g., representation gaps in specific occupations) may also affect the likelihood of COVID-19 exposure and contamination in some communities (e.g., Amish, Orthodox Jews) (Muurlink and Taylor-Robinson, 2020). By restricting access to services based on gender rotation, policies have been implemented in Panama, Peru, and Colombia in an effort to promote social isolation. As a result, transgender populations have been adversely affected (Perez-Brumer and Silva-Santisteban, 2020). Since the pandemic began, sexual and gender minorities have reported more coronavirus-related physical symptoms and more depression and anxiety symptoms (Moore et al., 2021).
Unexpected findings have been made in the field of mental health due to the influence of age. To protect older adults from COVID-19 infection, social isolation was imposed on this population, which led to ageism and segregation of older adults (Crimmins, 2020; Dowd et al, 2020). (Lichtenstein, 2021). Even though it was predicted that the isolation of aging populations would lead to worse mental health outcomes (Vahia et al., 2020), in several countries, the levels of stress reported by younger people consistently exceeded those of older people (Kowal et al., 2020). Cross-cultural differences have been found in the mental health outcomes of elderly people. The Fragile State Index, compiled by The Fund for Peace, found that older adults in countries with weaker state capacity were more likely to be depressed (2020). Corruption, population displacement, economic decline, institutionalized racism and inequity based on race and ethnicity all factor into this score.
The likelihood of death from COVID-19-related comorbidities (e.g., heart and liver diseases) is linked to social class, historically linked to racial and ethnocultural power dynamics as discussed in the following sections (Marmot and Allen, 2020), and presented different chronological patterns of virus transmission. While wealthy regions and social classes were primarily affected at the beginning of this pandemic, the virus spread more quickly among poorer populations and had a higher fatality rate in the later stages of the pandemic in countries like Germany, the United States, and Brazil. There may be a link between these findings and healthcare access and the viability of social distancing.
The pandemic has been politicized to an extreme degree in a number of countries. The pandemic was artificially linked to particular attitudes toward political parties or ideologies, influencing cultural scripts tied to political orientation and compliance with public health recommendations.
Government propaganda in Brazil encouraged citizens to go about their daily lives as usual. During his campaign, President Bolsonaro openly promoted conspiracies and provided false information about the symptoms, treatments, and severity of the pandemic in Brazil. When these measures were put in place by Bolsonaro’s supporters in society, including doctors, they encouraged them to disregard public health recommendations and acquire and use hydroxychloroquine, a substance used to treat malaria and other conditions with no proven efficacy against COVID-19. There were several deaths, and hydroxychloroquine was in short supply, limiting access to needed medication for patients with other illnesses (Biller et al., 2020; Ponce, 2020; Ricard and Medeiros, 2020).
Responses to COVID-19 in the United States, where the political system has traditionally been divided into two parties, have been closely tied to partisanship. In the wake of the 2016 presidential election, geolocation technology and debit card transaction data showed that residents of Democratic counties were more likely to adhere to stay-at-home orders and switch to online shopping (Painter and Qiu, 2020). Republican counties had lower mask use, less physical distance, and higher fatality rates than Democratic ones (Milosh et al., 2020). (Gollwitzer et al., 2020). Media consumption has a direct impact on people’s behaviors and beliefs about COVID-19. According to research conducted by the Centers for Disease Control and Prevention (CDC), people who watch MSNBC and CNN regularly are more likely to be aware of the dangers of COVID-19, take preventive measures, and be concerned about the early removal of government restrictions. Republicans, on the other hand, are more likely to watch cable news outlets like Fox News, which openly and repeatedly downplayed the severity of the pandemic in 2020, causing viewers to perceive less risk and take fewer precautionary measures associated with the pandemic. (Bruine de Bruin et al., 2020). Increased infection and death rates have also been linked to increased viewing of Fox News (Gollwitzer et al., 2020). The politicization of pandemic beliefs has also been observed in less polarized countries such as Canada, where “anti-lockdown” parties were allegedly organized with political motives (Keyes and Caruso-Moro, 2020).
We can also understand the political polarization and COVID-19 attitudes in light of Hacking’s looping effects if we consider political groups as artificially created categories of identities that enable intentional ways of acting (see also Vesterinen, 2020). Members of self-identified political categories are more likely to act in accordance with their group’s values and beliefs when they are tied to specific beliefs and attitudes about COVID-19.
People in countries and regions that were more severely affected by COVID-19 were more stressed, according to a study conducted in 26 countries by Kowal et al. (2020). Women, mothers with young children, singles, and people in their 20s and 30s, as well as those with less education, all reported higher levels of stress. Nurses, in particular, have reported higher levels of stress in various countries (Barzilay et al., 2020; Ilczak et al., 2020).
Under COVID-19, individual differences in optimism and intolerance of uncertainty have been shown to affect mental well-being and adaptation in the pandemic. Professionals who work from home (Biron et al., 2020) or health care professionals who work from home have better work routine adjustment if they have higher levels of optimism (Zhang et al., 2020). Collective optimism (the belief that everyone in a group is optimistic about the future) and collectivism (the belief that everyone in a group is optimistic about the present) are two cultural characteristics that can help people deal with stress and develop effective coping strategies like positive reappraisal (Biron et al., 2020).
Mental health can also be affected by an inability to accept feelings and thoughts that are uncertain. Cultural contexts differ greatly in terms of how much uncertainty one is used to, how much uncertainty one is able to tolerate, and how one can mitigate the negative effects of uncertainty through available practices. Uncertainty was raised throughout the world as a result of the pandemic due to both the fear of an unknown virus and the sudden shifts in daily routines, social interactions, financial and professional security, and rituals of mourning. It’s important to think about how new uncertainties and changes affect people’s ability to meet their basic needs, and how different populations interpret the term “uncertainty.” Some groups are more affected by the political pressure to re-open commerce in different parts of the world than others; thus, the duration of the uncertainty they experience can be strikingly different.
Cultural and socioeconomic factors play a significant role in determining the extent to which people are able to adapt to change, or are hindered by it. Technology workers in the United States were able to work from home, keep their high-paying jobs, and relocate to more affordable and less crowded areas because they reported lower levels of stress (Peyser, 2020). Low socioeconomic status individuals, on the other hand, are less able than others to self-isolate due to life circumstances (Templeton et al., 2020), and those with lower income employment who were already in a riskier socioeconomic bracket were more likely to lose their jobs completely or be forced to keep working in high-exposure conditions in order to save their jobs (Rollston and Galea, 2020).